Individual provider Active NPI

Wendy Lee Tooker, MS,CCC-SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1902816440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
854 Issued in NM
Practice address
4540 Samara Rd NW
Albuquerque, NM 87120-5245
Phone
(505) 897-3271
Fax
(505) 897-3271
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 854 NM Primary

Addresses

Primary practice location

4540 Samara Rd NW
Albuquerque, NM 87120-5245

Mailing address

4540 Samara Rd NW
Albuquerque, NM 87120-5245
Phone (505) 897-3271

Other identifiers 1

IdentifierTypeStateIssuer
000A0363MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
854NMMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902816440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SAMARA RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205245",
            "telephone_number": "505-897-3271",
            "fax_number": "505-897-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SAMARA RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205245",
            "telephone_number": "505-897-3271",
            "fax_number": "505-897-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOKER",
        "first_name": "WENDY",
        "middle_name": "LEE",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000A0363",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.